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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll A PLICABLE INFO MUST BE COMPL'r_ i LD FOR APPLICATION TO BE ACCEPTED - ` j Da e: O ' Permit Number: . ry �■ SCANNED BY a Building Permit Appl Planing and Development Services Bu ding and Code Regulation Division 23 0 Virginia Avenue, Fort Pierce FL 34982 Ph ne: (772) 462-1553 Fax: (772) 462-1578 Commercial W-AMIT APPLICATIONFOR: 1j "Aqun0D apnj q 4U@WjJ2d@(j bulla.ii i IcatiorfW L o 9nd ,, G 71 Add ess: So-7 s D h n s vh �;(� f ,7 2 ,'—epee f Kg Leg Description�1a lr—Ake All eX ®4 A, s o7� �L r i ` C'o c 5 S �a �'� fps 0�2N%`. Property Tax ID #: `'�-�fi✓c . Aq a se4 S,oIIV'e- t No. Site Plan Name: to) Block No. Projl ct Name:o"C_" Set acks Front /I� Back: �'�i`� Right Side: / Left Side: Additional work to be pertormed . under this permit — check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors TElectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Toll Ft of Constru on: �©0 �- ✓l6-2. Sq. Ft. of First Floor: Cos of Construction: �� G. 00 Utilities: _ Sewer _ Septic Building Height: Ndine Ci : /7--o !f`i`'f -e°,e State: Zi Code: 3 q_t4 Fax: Phi� ne No. 77R — 7 ke SoZ I S E-�/lail: /3- e— A o " A :;?Q %� Y h o o L im FiIM in fee simple Title Holder on next page ( if different fr rn the Owner listed above) Name: Company: Address: City: State: Zip Code: Fax: Phone No E-Mail State or County License If va;(ue of construction is 2500 or more, a RECORDED Notice of Commencement is required. S�UPPLEMEN A►l, Ct?NSTRU DRINK .N W IN'FORMAT07 DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: I I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone:- OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structured which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for { improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first ins tion. If you intend to obtain financing, consult with lender or an attorney before commencing wpflrecording your Notice of Commencement. Signa re of ner/ L ss / tractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA r STATE OF FLORIDA COUNTY OF ,I�, ���� COUNTY OF The f going instr ment was acknowledged before me T The forgoing instrument was acknowledged before me this day of 20Z by this day of 20_ by Name of pei son making statement. Name of person making statement. / Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Identification Type of Identification Produced L. Produced �S — (Sign ture 3. 9t1d9 1Pu (Signature of Notary Public- State of Florida ) State of Florlda-Not o 54c Commissio f 1 .= commission # GGQyz4rfy� Commission No. (Seal) ion :,�, QAc y orr, lssx Jun a 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLAN4 VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIE REVIEW REVIEW REVIEW DATE RECEIVED DATE ills COMPLETED ev. 8/2/17